Nutritional status among older residents with dementia in open versus special care units in municipal nursing homes: an observational study

BMC Geriatrics

Per Ole Iversen²  Helene Dahl Eide³  Carine Aukner¹ 

[1] Atlantis Medical College, Oslo, Norway;Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, POB 1046 Blindern, 0317 Oslo, Norway;Institute of Health, Nutrition and Management, Oslo and Akershus University College of Applied Sciences, Kjeller, Norway

关键词: Undernutrition;    Special care unit;    Open unit;    Nutritional status;    Nursing home;    Dementia;   

Others  :  857828
DOI  :  10.1186/1471-2318-13-26

 received in 2012-08-25, accepted in 2013-02-26,  发布年份 2013

【 摘 要 】

Background

Undernutrition is widespread among institutionalised elderly, and people suffering from dementia are at particularly high risk. Many elderly with dementia live in open units or in special care units in nursing homes. It is not known whether special care units have an effect on the nutritional status of the residents. The aim of this study was therefore to examine the nutritional status of residents with dementia in both open units and in special care units.

Methods

Among Oslo’s 29 municipal nursing homes, 21 participated with 358 residents with dementia or cognitive impairment, of which 46% lived in special care units. Nutritional status was assessed using the Malnutrition Universal Screening Tool and anthropometry.

Results

We found no differences (p > 0.05) in risk of undernutrition, body mass index, mid-upper arm muscle circumference or triceps skinfold thickness between residents in open units and those in special care units. Residents in special care units were significantly younger and stronger when measured with a hand-grip test.

Conclusions

We found no difference in nutritional status between nursing home residents with dementia/cognitive impairment in open units versus in special care units.

【 授权许可】

   
2013 Aukner et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]McWhirter JP, Pennington CR: Incidence and recognition of malnutrition in hospital. BMJ 1994, 308:945-948.
• [2]Saletti A, Lindgren EY, Johansson L, Cederholm T: Nutritional status according to mini nutritional assessment in an institutionalized elderly population in Sweden. Gerontology 2000, 46:139-145.
• [3]Corish CA, Flood P, Mulligan S, Kennedy NP: Apparent low frequency of undernutrition in Dublin hospital in-patients: should we review the anthropometric thresholds for clinical practice? Br J Nutr 2000, 84:325-335.
• [4]Stratton RJ, Hackston A, Longmore D, Dixon R, Price S, Stroud M, King C, Elia M: Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults. Br J Nutr 2004, 92:799-808.
• [5]Stratton RJ, Elia M, Green CJ: Disease-related malnutrition. An evidence-based approach to treatment. Wallingford: CABI; 2003.
• [6]Beds in institutions for elderly and disabled and homes for the aged and social services. Norway: Statistics Norway; 2001. [1997–2000]
• [7]Guerin O, Andrieu S, Schneider SM, Milano M, Boulahssass R, Brocker P, Vellas B: Different modes of weight loss in Alzheimer disease: a prospective study of 395 patients. Am J Clin Nutr 2005, 82:435-441.
• [8]Grundman M, Corey-Bloom J, Jernigan T, Archibald S, Thal LJ: Low body weight in Alzheimer’s disease is associated with mesial temporal cortex atrophy. Neurology 1996, 46:1585-1591.
• [9]Wang PN, Yang CL, Lin KN, Chen WT, Chwang LC, Liu HC: Weight loss, nutritional status and physical activity in patients with Alzheimers disease. J Neurol 2004, 251:314-320.
• [10]Poehlman ET, Dvorak RV: Energy expenditure, energy intake, and weight loss in Alzheimer disease. Am J Clin Nutr 2000, 71(suppl):650s-655s.
• [11]Ruths S: Beneficial effects of dementia care units. J Nor Med Assoc 2005, 9:1191-1194.
• [12]The content, quality and admission criteria for the provision of a residence in a nursing home in Oslo. : Oslo Nursing Agency; 2011. Accessed April 23, 2012 at http://www.sykehjemsetaten.oslo.kommune.no/getfile.php/Sykehjemsetaten%20(SYE)/Internett%20(SYE)/Dokumenter/Informasjonsmatriell/Innhold,%20kvalitet%20og%20inntakskriterier%20for%20tilbud%20om%20opphold%20i%20oslosykehjemmene,%20juni%202011.pdf webcite
• [13]Edvardsen DF, Aas E, Førsund FR: Efficiency in the care sector. Report 2/2000. Frischsenteret: Oslo; 2000.
• [14]Kirkevold O, Eek A, Engedal K: Development of residential care services facilitated for persons with dementia in Norway. Aging Clin Exp Res 2012, 24:1-5.
• [15]Rasmussen HH, Kondrup J, Staun M, Ladefoged K, Kristensen H, Wengler A: Prevalence of patients at nutritional risk in Danish hospitals. Clin Nutr 2004, 23:1009-1015.
• [16]Body measurementes. NHANES III; 1988. Accessed April 22, 2012 at http://www.cdc.gov/nchs/data/nhanes/nhanes3/cdrom/nchs/manuals/anthro.pdf webcite
• [17]Symreng T: Arm anthropometry in a large reference population and in surgical patients. Clin Nutr 1982, 1:211-219.
• [18]Ha L, Hauge T, Spenning AB, Iversen PO: Individual, nutritional support prevents undernutrition, increases muscle strength and improves quality of life among elderly at nutritional risk hospitalized for acute stroke: A randomized, controlled trial. Clin Nutr 2010, 29:567-573.
• [19]Luna-Heredia E, Martín-Peña G, Ruiz-Galiana J: Handgrip dynamometry in healthy adults. Clin Nutr 2005, 24:250-258.
• [20]Burden ST, Stoppard E, Shaffer J, Makin A, Todd C: Can we use mid upper arm anthropometry to detect malnutrition in medical inpatients? A validation study. J Hum Nutr Diet 2005, 18:287-294.
• [21]Luo H, Fang X, Liao Y, Elliot A, Whang X: Associations of special care units and outcomes of residents with dementia: 2004 national nursing home survey. Gerontologist 2010, 50:509-518.
• [22]Nobili A, Piana I, Balossi L, Pasina L, Matucci M, Tarantola M, Trevisan S, Riva E, Lucca U, Tettamanti M: Alzheimer special care units compared with traditional nursing home for dementia care: are there differences at admission and in clinical outcomes? Alzheimer Dis Assoc Disord 2008, 22:352-361.
• [23]Selbæk G, Kirkevold Ø, Engedal K: Psychiatric and behavioural symptoms and the use of psychotropic medication in special care units and regular units in Norwegian nursing homes. Scand J Caring Sci 2008, 22:568-573.
• [24]Guerin O, Andrieu S, Schneider SM, Cortes F, Cantet C, Gillette-Guyonnet S, Vellas B: Characteristics of Alzheimer’s disease patients with a rapid weight loss during a six-year follow-up. Clin Nutr 2009, 28:141-146.
• [25]Rolland Y, Andrieu S, Cantet C, Morley JE, Thomas D, Nourhashemi F, Vellas B: Wandering behavior and Alzheimer disease. The REAL.FR prospective study. Alzheimer Dis Assoc Disord 2007, 21:31-38.
• [26]Gillette-Guyonnet S, Nourhashemi F, Andrieu S, de Glisezinski I, Ousset PJ, Riviere D, Albarede JL, Vellas B: Weight loss in Alzheimer disease. Am J Clin Nutr 2000, 71(suppl):637s-642s.
• [27]Greenwood CE, Tam C, Chan M, Young KW, Binns MA, van Reekum R: Behavioral disturbances, not cognitive deterioration, are associated with altered food selection in seniors with Alzheimer’s disease. J Gerontol 2005, 60A:499-505.
• [28]Young KWH, Binns MA, Greenwood CE: Meal delivery practices do not meet needs of Alzheimer patients with increased cognitive and behavioral difficulties in a long term care facility. J Gerontol 2001, 56A:M656-M661.
• [29]Dementia plan 2015“the good day”. Oslo: Ministry of Health and Care Services; 2007.